Millions drop Affordable Care Act coverage after subsidies expired and costs rise

Millions of Americans have lost their health insurance coverage through the Affordable Care Act (ACA) as enhanced federal subsidies, designed to make plans more affordable, expired at the end of 2025. New figures reveal approximately 3 million fewer people held ACA plans in February 2026 compared to the same time last year, a significant 13% drop from 22.1 million to 19.2 million enrollees. This dramatic decline is largely attributed to skyrocketing premiums that many could no longer afford after the extra financial help disappeared. These enhanced premium tax credits, first boosted by the American Rescue Plan Act and then extended by the Inflation Reduction Act through 2025, were instrumental in driving ACA enrollment to record highs, making coverage accessible to many middle-income households by eliminating the 'subsidy cliff'. With their expiration, average monthly premium payments have surged, in some cases by over 20% or even double to triple digits, pushing health insurance out of reach for vulnerable populations. The Centers for Medicare & Medicaid Services data confirm this stark reversal, with some attributing part of the drop to weeding out fraudulent enrollments, though analysts largely point to the subsidy lapse as the primary cause. Looking ahead, healthcare affordability is set to remain a hot-button issue, especially with the November elections approaching. Experts like KFF project further declines in ACA enrollment throughout 2026, potentially seeing numbers fall as low as 17.5 million. While some states are stepping in with their own subsidies to mitigate the impact, the lack of federal consensus leaves millions facing tough choices between higher-deductible plans or going uninsured, putting immense pressure on policymakers to find a sustainable solution for healthcare access.